Active NPI
Martin Mortens, DO
- Family Medicine Physician
- Urbandale, IA
National Provider Identifier
1699786996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 03024
- Practice address
- 6200 Aurora Ave
Urbandale, IA 50322-2800 - Phone
- (515) 270-1177
- Fax
- (515) 643-9361
- NPI assigned
- Aug 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 03024 | IA | Primary |
Addresses
Primary practice location
6200 Aurora Ave
Urbandale, IA 50322-2800
Mailing address
PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 270-1177
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2125005 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264723200000",
"number": "1699786996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1475",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503051475",
"telephone_number": "515-270-1177",
"fax_number": "515-643-9361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6200 AURORA AVE",
"city": "URBANDALE",
"state": "IA",
"postal_code": "503222800",
"telephone_number": "515-270-1177",
"fax_number": "515-643-9361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORTENS",
"first_name": "MARTIN",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2010-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "03024",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2125005",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Urbandale, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.